a. There are many commercial ileostomy appliances available.

Each patient should be fitted with the style that is most comfortable and convenient for that patient’s lifestyle. Appliances should be applied, removed, and cleaned in accordance with the manufacturer’s directions.

b. The appliance worn over the stoma of a conventional, or “incontinent,” ileostomy must be drained several times daily.

(1) For convenience, this can be done at the same time the patient urinates.

(2) Pouches are equipped with an emptying spout at the bottom, allowing the contents of the pouch to be drained directly into the toilet.

c. An appliance can normally be left in place for 2-4 days before being changed. A regular schedule for changing the appliance should be established to avoid leakage.

d. Each time the appliance is changed, the peristomal skin should be washed with soap and water and inspected for irritation or breakdown.

(1) Although each patient will develop his own routine for changing the appliance, it is best to perform this care when the ileostomy is quiet. For example: before a meal, 2 hours after a meal, or at bedtime.

(2) If desired, the patient may remove the appliance, shower, or bathe, and then apply a clean appliance.

e. The stoma should be covered to absorb drainage and prevent excoriation of the peristomal skin while changing appliances.

(1) A gauze dressing may be used to cover the stoma.

(2) A small vaginal tampon may be gently inserted into the stoma.